Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Colorado (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Smith Agency (NPI 1881137743)

Field	Value
Entity Type	Organization
Organization	Smith Agency
Address	14364 E Evans Ave
City	Aurora
State	CO
ZIP	80014
Taxonomy	Foster Care Agency
NPI Enumerated	November 28, 2016

Payer Source	Total Paid
Medicaid	$51.9M
Medicare	$0

Key Findings

SMITH AGENCY is effectively a Medicaid-centered operation: it reports $51.9M in lifetime Medicaid revenue and has no Medicare billing on file, indicating the organization is functionally single-payer with Medicaid as its primary revenue source. The NPI was enumerated on 2016-11-28 (~10 years ago), so this Medicaid activity has been established over roughly a decade of enrollment.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicaid codes by revenue account for 98.0% of this provider's total Medicaid revenue. In particular, T2016 (per diem residential habilitation) alone represents $33.7M or 65.0% of Medicaid revenue, and T2021 (day habilitation, per 15 minutes) contributes $15.6M or 30.1%, so these two codes dominate the payer mix.

The coding mix and volumes point to a service-line profile focused on waiver-funded habilitation and residential supports: heavy billing for T2016 (Habilitation, residential, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes) suggests the provider operates residential habilitation programs and structured day habilitation services rather than acute medical care or typical ambulatory procedures. Supporting services such as non-emergency transportation (T2003) appear secondary, consistent with an organization providing residential and day program access rather than clinical treatment.

Competitive standing by code is generally modest-to-typical statewide rather than dominant. T2016 ranks #76 of 191 in-state (61th percentile; typical, unremarkable volume for this code), while T2021 ranks #54 of 290 (82th percentile; typical, unremarkable volume for this code), indicating stronger relative presence in day habilitation than in residential habilitation but not a top-tier statewide position. T2003 ranks #109 of 283 (62th percentile; typical, unremarkable volume) and T2019 ranks #46 of 102 (55th percentile; typical, unremarkable volume), reinforcing a pattern of ordinary competitive placement across multiple waiver services.

There are anomalous zero-paid claim lines that warrant attention as potential reporting or payment-process artifacts: T2034 (Crisis intervention, waiver; per diem) shows 964 claims with $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue) and ranks #31 of 162 (81th percentile; typical, unremarkable volume for this code). Similarly, T2015 (prevocational, per hour) lists 21 claims with $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue) and ranks #17 of 17 (0th percentile; typical, unremarkable volume for this code). These entries suggest episodes were recorded but resulted in no paid dollars in the dataset.

The provider’s dependence on two high-revenue waiver codes implies operational and reimbursement concentration risk: roughly two service lines (residential habilitation and day habilitation) drive the bulk of reported Medicaid receipts, so changes in state waiver policy, reimbursement rates, or contract mix affecting T2016 or T2021 could materially affect overall revenue. Analysts should treat payor or policy shifts for waiver programs as principal business risks for this entity.

Given the Foster Care Agency taxonomy registration combined with the observed code mix, the organization appears structured around long-term supportive services and day programs commonly funded through waiver mechanisms rather than short-term clinical encounters. This alignment of taxonomy and dominant codes supports a business model centered on ongoing residential/day habilitation services, supplemented by transportation and occasional supported employment billing (T2019).

Overall, SMITH AGENCY presents as an established, Medicaid-dependent provider with concentrated revenue in waiver habilitation services and typical statewide market positioning: not a statewide leader in all its codes but with above-typical presence in day habilitation (T2021 at the 82th percentile) and sizeable per-diem residential revenue (T2016 at 65.0% of Medicaid revenue). The dataset contains some $0-paid claim lines that deserve follow-up to confirm whether they reflect denials, offsets, non-covered units, or reporting artifacts.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	7,670	$4,400	$33.7M
T2021	Day habilitation, waiver; per 15 minutes	20,340	$770	$15.6M
T2003	Non-emergency transportation; encounter/trip	4,900	$300	$1.5M
T2019	Habilitation, supported employment, waiver; per 15 minutes	2,780	$380	$1.1M
T2015	Habilitation, prevocational, waiver; per hour	20	$0	$0
T2034	Crisis intervention, waiver; per diem	960	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.

Claims Volume vs. Colorado Distribution

Smith Agency — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	76	190	3,890	$290	$12.4M
T2021	Day habilitation, waiver; per 15 minutes	54	290	3,700	$160	$2.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	46	100	1,940	$200	$1.5M
T2003	Non-emergency transportation; encounter/trip	109	280	2,640	$20	$881.3K
T2015	Habilitation, prevocational, waiver; per hour	17	20	1,670	$120	$578.5K
T2034	Crisis intervention, waiver; per diem	31	160	360	$0	$0

Nearby Providers

Other providers in the same ZIP code as Smith Agency, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Teamselect Home Care Of Colorado, LLC	CO	Home Health Agency	$0	$194.9M
Clinton Home Care, Inc.	CO	In Home Supportive Care Agency	$0	$60.3M
Colorado Spirit Home Care	CO	In Home Supportive Care Agency	$0	$46.9M
Alternative Choice Home Care Nursing, LLC	CO	Home Health Agency	$0	$42.7M
Care On Call Colorado, LLC	CO	In Home Supportive Care Agency	$0	$33.8M
Atlas Home Health, Inc.	CO	Home Health Agency	$0	$31.3M
Mercy Home Services	CO	In Home Supportive Care Agency	$0	$27.9M
Community Support Services, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$27M
Support Management	CO	Developmentally Disabled Services Day Training Agency	$0	$26.2M
Thrive Community Options	CO	Developmentally Disabled Services Day Training Agency	$0	$25.3M

Smith Agency — Billing Profile & Reimbursement Data

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Smith Agency — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References